Jan 18 Adaptability: A Prerequisite for Medicine

By Priya Misra•
In medical school, classes are usually graded on an Honors, High Pass, Pass, or Low Pass scale. When I first began medical school I wanted to do the very best I could—I wanted to honor every class that was possible. Once school actually started, however, that thought quickly fled my mind. It came to the point where I was barely keeping up with my schoolwork; I constantly felt behind and didn’t know how to study anymore.

In college, I was a chemistry major, so I was used to taking hard classes; the information was always just hard enough that although I spent many hours studying, I still felt confident and prepared for the exam. There was always an end point to my studying, a finite amount of information that I was expected to know. After completing a certain number of questions, I was confident that I could close my book and squeeze in a few hours for my friends and family on the weekend. But in medical school, the studying never seemed to end—whenever you thought you knew enough, there was always more information to know. Sometimes I felt like I could study for 24 hours straight and still not know enough for the exam. And because the breadth of knowledge was so vast, you truly had to use your time wisely, whereas in college I liked to write out all my notes, but I just didn’t have time to do that anymore. I had to learn how to just read and absorb information quickly, but in an effective way so that I could apply it in the future.

Even though I could admit that my study habits had to change, I was so set in my old ways that it was hard to actually alter them. But, after my first Anatomy exam I learned that I had no choice except to listen to the advice that the second years had for me, like start with questions first and read necessary materials after, which was alien to me. I knew I had to change my study habits as quickly as I could. That was probably one of the hardest things for me to come to terms with when transitioning from college to medical school: there’s just not enough time to continue with old study habits and the information you will learn here is extremely different than what you learned in undergrad—both in content and in volume. And most daunting of all, you actually need to remember this stuff for life— you can’t just learn something and push it out of your brain after the test was over. In college, I knew that if I forgot the exact mechanism of balancing a reduction-oxidation reaction, people were not going to die; I could easily look it up, practice it again, and continue with my experiment. But once I become a pediatrician, if I forget the symptoms and criteria for Kawasaki’s Disease, then my 5-year-old patient with a rash could end up developing heart failure if left it untreated. It didn’t take long for me to realize that yes, there is a lot of information for me to learn, and unfortunately yes, I need to remember and understand everything I’m reading because it determines whether or not I can effectively treat my patients.

As I reflect on what helped me in school and what hurt me, I realize that adaptability is a huge part in one’s success in medicine. We learn from day one in Anatomy Lab that things are not always going to go the way we hoped they would; most of the time we are wrong, and just when we think we have the hang of something it slips away from our grasp. I cannot begin to recount how many times my anatomy group changed our study plans. It went from idealistic: “Okay, let’s all read tonight to be totally prepared for tomorrow’s lab” to frantic: “Well, maybe we can just learn the information while we’re in lab tomorrow” to realistic: “Whatever, if the professor comes over and asks me something and I don’t know the answer, then I’ll be honest and he can teach me while I’m there.” Anatomy Lab was a beast of a course, and the sooner we realized that it was normal not to know everything immediately, and refined our individual study plans, the easier it was to actually learn the information.

I truly feel like the ability to adapt to a new and uncomfortable situation is vital in medical school. After every exam I think it’s important to ask yourself which study tactics worked for you and which didn’t. As a doctor, when you are in the ER or the OR and a patient starts coding, you won’t have time to think or feel sad about the way things ended up; it’s vital that you are able to think on your feet and quickly adapt to the situation and save your patient’s life.

But it’s not just how you study that has to change, it’s also what you expect of yourself and your perspective on reality that has to adapt. It’s funny how quickly I abandoned my “honoring plan” and reverted to my “passing plan.” Biochemistry is not and has never been one of my strengths; I remember telling myself before taking my first exam that if I got in the mid 80s I would be proud of myself. I did, and I was overjoyed.

Then I saw the average of the class…

I had done right around the average and immediately I felt deflated. Why was I so upset? I got the score I had set out to get, but now just because it was around the average I felt that it wasn’t good enough anymore. It is extremely hard getting used to the idea that whereas in college you were near the top of your classes, which is what helped you get into medical school, now you are nearer to the middle or bottom because you are studying with the cream of the crop; everyone here was the best at where they were. It is so hard to come to terms with that fact, and getting used to the idea that no, most of the time you won’t know what is going on in class, and no, you may not be at the top of your class. The sad thing is that we will never take a step back and realize that even though we may just be “passing” in medical school, that in itself is an extremely difficult thing to do and is something that we should all be so proud of. However, the unspoken competition, the extremely high averages, the never-ending pressure of having to get into a good residency program, never lets us just be happy and thankful that we passed all of our classes.

There are a lot of changes that hit you all at once when you start medical school, whether it’s accepting that your study habits have to change, or realizing that your academic performance may not be as great as it was in college—that is just the nature of medical school, and the more you have an open mind, the easier it will be to adapt to these changes. In my opinion, medical school prepares you for your future as a physician through more than just teaching you the basic science of medicine: it teaches you how to think like a doctor, how to conduct yourself like a professional, and how to deal with the emotions that come with this career. For example, through its difficulty and breadth of information, medical school teaches you how to address failure, stress, and change on an academic level, arming you with tools to use when you face these emotions on a clinical level. It shows you how to multitask, face your own shortcomings, and step outside of your comfort zone, so that when you are expected to do so as a physician, these skills have already been developed. But at the heart of this multidimensional education is your ability to adapt, to accept, and to stay open-minded. Only with these qualities will you be able to embrace medical school for what it is and be prepared for the real world that lies ahead.